BHCG Monitor: Focus on Health Care Benefits

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BHCG Monitor: Health Care Reform


Promoting Conversations Between Physicians and Patients

The Choosing Wisely campaign

Based on numerous studies, experts concur that there is too much waste in the health care system in the United States. The Congressional Budget says up to 30 percent of the care delivered in the U.S. is duplicative or unnecessary. According to a survey conducted by researchers at Dartmouth College, nearly half of primary care physicians say their own patients get too much medical care.  

Not only does it fail to improve people’s health, unnecessary care increases costs and may compromise patient safety. For these reasons it is critical that both physicians and patients do their part to reduce care that is unnecessary. That effort begins with patients and physicians having conversations about making wise, informed health care treatment decisions. What can be done to spur these conversations?

A national campaign

Choosing Wisely®, an initiative of the American Board of Internal Medicine (ABIM) Foundation aims to promote conversations between physicians and patients by helping patients choose care that is:

  • Supported by evidence
  • Not duplicative of other tests or procedures already received
  • Free from harm
  • Truly necessary

More than 40 medical specialty societies, representing more than 500,000 physicians have joined the ABIM Foundation in the Choosing Wisely campaign. Each specialty society has developed its own list of Five Things Physicians and Patients Should Question. These lists represent specific, evidence-based recommendations physicians and patients should discuss to help make wise decisions about the most appropriate care based on their individual situation. Each list provides information on when tests and procedures may be appropriate.

Consumer Reports has also joined the campaign, developing communications resources for dissemination to consumer-oriented organizations to help educate patients on making wise health care decisions (see below about an Employer Toolkit Consumer Reports has developed to assist employers communicate with their employees).

Closer to home

In March 2013, one of the BHCG’s strategic partners, the Wisconsin Collaborative for Healthcare Quality (WCHQ) was one of 21 regional health collaboratives, state medical societies, or specialty societies to be awarded a two-year grant by the ABIM Foundation. This funding is designed to extend the reach of the Choosing Wisely campaign.  WCHQ has begun an initiative to promote these conversations between patients and physicians to ensure that patients receive the right care at the right time.

Using a multi-stakeholder advisory group comprised of providers, consumers and purchasers to guide its efforts, to date, WCHQ has produced two documents – one for patients, the other for physicians – to help create a new dialogue between physician and patient. The first document, designed for patients, is an overview piece, posing general questions a patient could ask their physician regardless of the care proposed (Five Questions to Ask Your Doctor Before You Get Any Test, Treatment or Procedure). 

The second document, WCHQ’s Top 10 Choosing Wisely Recommendations, designed with physicians in mind, was developed by culling through the lists of all the specialty societies. The list identifies specific tests/procedures to avoid and provides rationale from the specialty societies. WCHQ is actively engaging in a wide variety of outreach activities with its provider members over the next two years to promote the Choosing Wisely campaign.

Employer toolkit available

As reported in the June 2013 edition of The Catalyst, the National Business Coalition on Health (NBCH) and Pacific Business Group on Health (PBGH), working in collaboration with Consumer Reports, released the Choosing Wisely Employer Toolkit. These materials are designed to help employers of all sizes educate their employees about the importance of talking with their physicians about their medical care. Consumer Reports, using their expertise in creating consumer-friendly communications, has translated the clinical recommendations into insightful tips and free resources for the general public. 

It is critical physicians and patients have the important conversations necessary to ensure the right care is delivered at the right time. The Choosing Wisely campaign is designed to facilitate these conversations.


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BHCG Monitor: Focus on Health Care Benefits - April 2012